|Last Updated||November 4, 2015|
California employees have the right to designate a personal physician outside the employer's MPN whom they wish to be treated by in the event of an injury, as long as the employee provides written notice of their personal physician. This is an optional form employers may provide to employees wishing to predesignate a physician, if the employer does not develop their own form.
Information about worker's compensation regulations regarding predesignation of personal physicians is available on the CA Dept. of Industrial Relations website.
|DWC 9783 Notice of Predesignation of Personal Physician (CA).pdf|
|DWC 9783 DESIGNACIÓN PREVIA DE MÉDICO PERSONAL|
|Link to CA Division of Workers' Compensation forms directory|